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Treatment of Oral Cancer in Germany

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Diagnosis for oral cancer
816.35
Chemoradiotherapy for oral cancer
22504
Chemotherapy for oral cancer (1 course)
1996.65

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Oral, Maxillofacial Surgery

The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
Diagnosis for oral cancer
2801.7
Chemoradiotherapy for oral cancer
39688.4
Chemotherapy for oral cancer (1 course)
6877.8

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Oral, Maxillofacial Surgery, Facial Plastic Surgery

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Diagnosis for oral cancer
2362.35
Chemoradiotherapy for oral cancer
30421.45
Chemotherapy for oral cancer (1 course)
6073.05

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to the reputable Focus magazine, the University Hospital Carl Gustav Carus Dresden ranks among the top five German hospitals! The hospital is the benchmark for modern high-quality medicine. Positioning itself as a maximum care medical facility, the hospital represents all medical fields. There are 26 specialized depart
Diagnosis for oral cancer
3032.25
Chemoradiotherapy for oral cancer
31043.5
Chemotherapy for oral cancer (1 course)
8036.35

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Diagnosis for oral cancer
2537.8
Chemoradiotherapy for oral cancer
37410.45
Chemotherapy for oral cancer (1 course)
6600.85

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
Diagnosis for oral cancer
3093.15
Chemoradiotherapy for oral cancer
30257.6
Chemotherapy for oral cancer (1 course)
5825.1

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Oral and Maxillofacial Surgery

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Diagnosis for oral cancer
2793
Chemoradiotherapy for oral cancer
39449.15
Chemotherapy for oral cancer (1 course)
6988

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Oral, Maxillofacial and Facial Plastic Surgery

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Diagnosis for oral cancer
2782.85
Chemoradiotherapy for oral cancer
30952.15
Chemotherapy for oral cancer (1 course)
7017

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Oral and Maxillofacial Surgery, Facial Plastic Surgery

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Diagnosis for oral cancer
2574.05
Chemoradiotherapy for oral cancer
30765.1
Chemotherapy for oral cancer (1 course)
5839.6

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
Diagnosis for oral cancer
2574.05
Chemoradiotherapy for oral cancer
31055.1
Chemotherapy for oral cancer (1 course)
5781.6

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Diagnosis for oral cancer
2516.05
Chemoradiotherapy for oral cancer
30538.9
Chemotherapy for oral cancer (1 course)
5845.4

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Oral, Maxillofacial, Plastic Surgery

According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
Diagnosis for oral cancer
2868.4
Chemoradiotherapy for oral cancer
30779.6
Chemotherapy for oral cancer (1 course)
5813.5

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Oral and Maxillofacial Surgery

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Diagnosis for oral cancer
2658.15
Chemoradiotherapy for oral cancer
39408.55
Chemotherapy for oral cancer (1 course)
6886.5

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Adult and Pediatric Oral, Maxillofacial Surgery

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Diagnosis for oral cancer
2402.95
Chemoradiotherapy for oral cancer
37293
Chemotherapy for oral cancer (1 course)
5843.95

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
Diagnosis for oral cancer
2584.2
Chemoradiotherapy for oral cancer
37907.8
Chemotherapy for oral cancer (1 course)
6393.5

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Oral, Maxillofacial Surgery

According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
Diagnosis for oral cancer
0
Chemoradiotherapy for oral cancer
0
Chemotherapy for oral cancer (1 course)
0

University Hospital Giessen UKGM

9.5/10
location_onGermany, Giessen

Department of Adult and Pediatric Oral, Maxillofacial Surgery

The University Hospital Giessen UKGM positions itself as an ultramodern medical facility with outstanding quality of medical care. The hospital presents almost all areas of medicine, ranging from ophthalmology to traumatology and dentistry. The priorities of the hospital’s activities include surgery, neurosurgery, oncology
Diagnosis for oral cancer
2472.55
Chemotherapy for oral cancer (1 course)
5806.25
Treatment of oral cancer with metastases to lymph nodes with tumor resection and cervical lymph nodes dissection
26390
| from Booking Health GmbH

Oral cancer in Germany is treated with surgical intervention. Many patients also undergo postoperative radiation and chemotherapy. German specialists achieve good results at any stage of the pathology, even advanced. They not only cure cancer, but also restore the appearance of the patient, as well as the functions of the oral cavity: speech, chewing, and swallowing.

Content

  1. What is oral cancer?
  2. Principles of treatment
  3. Surgical treatment
  4. Therapeutic tactics for inoperable tumors
  5. Treatment of cancer recurrence
  6. Treatment of cancer with distant metastases
  7. Radiation therapy as an independent treatment method
  8. Why is it worth undergoing treatment in Germany?

What is oral cancer?

 

Oral cancer is a group of malignant neoplasms found in the non-keratinized epithelium of the mucous membrane of the cheeks, palate, gums, floor of the mouth, or tongue. The pathology develops due to smoking, chronic infection, or chronic trauma: for example, poorly fitting dentures, or damaged and improperly located teeth. The development of oral cancer is often preceded by long-term precancerous diseases.

The most common histological type of oral cancer is squamous cell carcinoma. It accounts for 97% of cases. The most common remaining cases are usually adenocarcinoma, which develops from the cells of minor salivary glands.

In most cases, the first signs of oral cancer are ulcers, erosions, or cracks that cause discomfort when chewing and swallowing. Burning and tingling may also indicate cancer. As the disease progresses, 100% of patients start feeling pain. It shoots up the ear and temple. Due to the decay of the tumor, bad breath appears.

Diagnostic methods: 

  • cytological examination of scrapings from the oral cavity and puncture samples of enlarged lymph nodes to confirm the diagnosis;
  • instrumental tests: ultrasound, CT or MRI, as well as laryngoscopy and PET, if indicated;
  • histological examination of the surgical material after the operation.

Principles of treatment

 

The main treatment method is surgery. It can be performed immediately or after neoadjuvant treatment. Preoperative therapy can reduce the size of the tumor and eliminate some metastases. However, a good response to therapy is not a valid reason to reduce the scope of the planned surgical intervention.

For some patients with stage T1 or T2, surgery will be the only treatment needed to cure the disease. At stage T3 or T4, or when there is the presence of risk factors for recurrence, postoperative therapy is required.

Characteristics of the primary tumor are as follows: 

  • Т1 – tumor up to 2 cm with an invasion depth of up to 5 mm; 
  • Т2 – tumor up to 4 cm with an invasion depth of up to 10 mm; 
  • Т3 – tumor more than 4 cm with an invasion depth of up to 20 mm; 
  • 4а – moderately, locally advanced cancer (invasion only in adjacent tissues); 
  • 4b – locally advanced cancer, spread to the masticatory system, sphenoid bone, base of the skull, coverage of the carotid artery. 

With T1 and T2, the patient may require postoperative treatment in the following situations:

  • positive resection margin; 
  • tumor invasion in the tissue near the nerves, blood and lymphatic vessels; 
  • detection of metastases in distant lymph nodes; 
  • residual tumor if it cannot be removed during the second surgical intervention. 

Chemoradiation therapy may be an alternative to surgery. It is used in cases where surgery has been refused, as well as in patients who are considered unsuitable candidates for surgical treatment. Contraindications for radical surgery are as follows:

  • direct spread of the tumor to the lymph nodes; 
  • invasion in the skin;
  • damage to the structures of the mediastinum; 
  • invasion in the prevertebral fascia and cervical vertebrae. 

In these cases, surgery becomes risky, and complete tumor removal is unlikely.

Surgical treatment

 

Primary tumor focus removal is the main method of treatment for patients with oral cancer. The doctor removes the primary tumor using an en-bloc technique, without dividing it into fragments. In this case, the risk of recurrence is minimal. The scope of the surgical intervention is planned based on the data from an instrumental diagnosis.

Sometimes, the neoplasm is adjacent to the nerve, which does not exclude the perineural invasion of the tumor. In this case, the nerve is exposed above and below the neoplasm and resected to obtain a clean resection margin.

Doctors often have to remove a fragment of the bone tissue from the lower jaw. Surgeons perform a marginal, planar, or sagittal resection if the neoplasm involves or is adjacent to the periosteum. The degree of jaw resection depends on the severity of the lesion, which is determined before surgery using instrumental tests.

After the surgical intervention, the removed material is examined. The key to successful cancer treatment is a clean resection margin. The distance to the visible tumor should be at least 2 cm. The margin is considered clean if the distance from the border of the removed tissue to the cancer cells is at least 5 mm. If the distance is smaller, the margin is called close.

Cervical lymph node dissection is a stage of the operation involving the removal of cervical lymph nodes. The scope of lymph node dissection depends on the stage of the disease. If there are no clinical signs of metastasis, then the lymph nodes of the first three levels are removed. If metastases are found, then the lymph nodes of five levels are removed.

The lymph nodes are usually removed on one side only. But, if the thickness of the tumor, according to a computed tomography scan, exceeds 4 mm, then the lymph nodes on the other side are also removed, due to the high probability of micrometastases. Lymph node dissection not only allows doctors to accurately determine the stage of the disease in order to better plan the postoperative treatment, but also reduces the likelihood of tumor recurrence. In addition, a bilateral lymphadenectomy is required if the cancer has spread beyond the midline.

With a small tumor size – up to 2 mm, no lymph node dissection is required. In this case, the risk of any metastasis spread is minimal.

Sentinel lymph node biopsy is a high-tech procedure that replaces lymph node dissection in some patients. It is used in German hospitals. Doctors inject a radioactive substance into the tumor site, and then use a gamma camera to check which lymph nodes it accumulates in. These nodes are called sentinel nodes: they are the first to collect lymph from the tumor. The sentinel lymph nodes are then removed and examined. If there are no signs of cancer in them, then the cancer has not spread to the lymph nodes that are located farther from the tumor. Therefore, there is no need to remove them. If cancer metastases are detected in the sentinel lymph nodes, the patient undergoes cervical lymph node dissection in the standard scope.

Therapeutic tactics for inoperable tumors

 

If surgical treatment for cancer is considered impossible, the management of a patient differs, depending on their health status. The patient's general condition is assessed according to the ECOG (Eastern Cooperative Oncology Group) classification. The lower the score, the better the patient's condition.

The therapeutic tactics for the inoperable tumor are as follows: 

  • ECOG 0-1 – induction chemotherapy, then chemoradiotherapy, after which, the question of the possibility of performing the surgical operation is reconsidered.
  • ECOG 2 – external beam radiation therapy or polychemotherapy is carried out. 
  • ECOG 3 – palliative radiotherapy or palliative chemotherapy (lower doses, fewer drugs to reduce the risk of side effects and complications).

Treatment of cancer recurrence

 

The best way for cancer treatment that has recurred after surgery is a second surgery. Nonetheless, it is not always possible. The doctor will only perform surgery if he believes that it is possible to remove the cancer, in order to achieve R0 status (total removal, without residual tumor left).

Treatment options for inoperable cancer recurrence are as follows: 

  • chemoradiotherapy; 
  • radiation therapy; 
  • chemotherapy.

Treatment of cancer with distant metastases

 

Treatment options for stage 4 cancer with distant metastases are as follows: 

  • surgery;
  • radiation therapy;
  • chemotherapy.

A surgical intervention is performed only if the doctor believes that the tumor can be removed with an R0 status. With a newly established cancer diagnosis, there may be a combined intervention. Doctors will simultaneously remove tumors from different parts of the patient's body. In addition, some patients will experience recurrences developed from distant metastatic foci, from the previously removed primary tumor. In this case, surgery to remove the metastasis is indicated if there are no signs of local cancer recurrence.

In the case of inoperable metastatic cancer, doctors irradiate the metastatic site using radiation therapy. But, if there are many metastases, only chemotherapy is conducted.

Radiation therapy as an independent treatment method

 

In some cases, radiation therapy is conducted without surgery. It can cure cancer, but this is unlikely. If the cancer is not completely cured, long-term survival of the patient is achieved, since a long-term remission of the disease will occur. The tumor is reduced in size, so the symptoms regress.

Radiation therapy options: 

  • external beam radiation therapy – for the primary tumor and lymph nodes; 
  • brachytherapy – contact irradiation with radioactive seeds introduced into the tumor (used for neoplasms up to 4 cm in size). 

If the patient's state of health allows, then chemotherapy is also included in the treatment regimen. The simultaneous use of two methods provides better results, but has a higher toxicity.

Why is it worth undergoing treatment in Germany?

 

Thousands of patients from all over the world travel to Germany for cancer treatment. Doctors with high reputability in the world of medicine work in this country, and state-of-the-art equipment is used in the hospitals here. Here are a few reasons for you to undergo treatment in Germany:

  • the most cases of oral cancer are cured here;
  • surgical treatment is possible even at an advanced stage, including in cases with a spread of distant metastases;
  • high performance in the reconstructive stage of surgical intervention to restore all the functions of the oral cavity and dentoalveolar system;
  • high performance of skin grafting to improve the person's appearance after surgery;
  • the use of modern methods of radiation therapy, which have a minimal effect on healthy tissues, reducing the risk of post-radiation complications.

To undergo diagnosis and treatment of oral cancer in Germany, please use the Booking Health service. On the website you have the opportunity to see up-to-date and accurate information about the cost of treatment in Germany, compare prices in different German hospitals and book a medical care program at a favorable price. Diagnosis and treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.

You are welcome to leave your request on the website of the medical tourism operator, Booking Health. An employee will contact you, consult with you, and answer all your questions. We will take care of the organization of your trip abroad. We will provide the following benefits to you:

  • We will select the best German hospital, whose doctors specialize in the diagnosis and treatment of oral cancer and achieve the best results;
  • We will help overcome the language barrier and establish your communication with the doctor at the German hospital;
  • The waiting time for diagnosis and treatment will be reduced, and you will receive medical care on the most suitable dates for you;
  • We will reduce the price. The cost of treatment in Germany will be lower than usual due to the elimination of overpricing and coefficients for foreign patients;
  • Our specialists will solve any organizational issues: paperwork, transfer from the airport to the German hospital and back, hotel booking, and interpreting services;
  • We will prepare your documents and translate them into English or German. You do not have to repeat any previously performed diagnostic procedures;
  • We will maintain contact with the German hospital after the completion of your diagnosis and treatment;
  • We will arrange additional medical examinations and treatment, if required;
  • We will buy your medicines in the other country and forward them to your native country.

While the best specialists in the world are taking care of your health, the Booking Health staff will help reduce your cost of treatment in Germany and take care of all your travel arrangements.

 

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

European Society for Medical Oncology

Cancer Research Institute

NORD - National Organization for Rare Disorders




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